Keith Payton

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DS0000010185 Issued in TN

Practice address

217 Highway 46 Ste D
Dickson, TN 37055

Phone

(615) 326-5010

NPI assigned

May 8, 2014

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1399507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1902217292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 HIGHWAY 46 STE D",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552507",
            "telephone_number": "615-326-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 HIGHWAY 46 STE D",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "37055",
            "telephone_number": "615-326-5010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2124 Cornell Rd",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441063804",
            "country_code": "US",
            "telephone_number": "216-368-3249",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2124 Cornell Rd",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441063804",
            "country_code": "US",
            "telephone_number": "216-368-3249",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAYTON",
        "first_name": "KEITH",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-08",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OH",
            "license": "RES3352",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TN",
            "license": "DS0000010185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Belinda Patrick, O.D.
• Leah M Patrick, DDS
• Ashley Patterson
• Ramesh Pavuluri, D.PM
• Vijay Pavuluri, D.P.M
• William Peach
• Annmarie Pederson, DMD
• Tiffany Marie Pendarvis, LPN
• Savannah Pendergrass, DPT
• Richard Penfield

• Orthodontics and Dentofacial Orthopedics Dentistry in Dickson, TN
• Providers in Dickson, TN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.